person-centered focus on function: speech sound disorder · person-centered focus on function:...

What are person-centered functional goals?

• Goals identifi ed by the child, in partnership with the clinician and family, that allow participation in meaningful activities and roles

Why target person-centered functional goals?

• To maximize outcomes that lead to functional improvements that are important to the child and/or family

• To optimize the child’s potential to participate in meaningful activities

• To facilitate a partnership that ensures the child and family have a voice in the care received and outcomes achieved

• To demonstrate the value of skilled services to payers

What is the ICF, and how does it help?

The International Classifi cation of Functioning, Disability and Health (ICF) was developed by the World Health Organization (WHO). It provides a framework to address a child’s functioning and disability related to a health condition within the context of that person’s activities and participation in everyday life.

What are person-centered functional goals?

• Goals identifi ed by the child, in partnership with the clinician and family, that allow participation in meaningful

PERSON-CENTERED FOCUS ON FUNCTION:

Speech Sound Disorder PERSON-CENTERED FOCUS ON FUNCTION:

Speech Sound Disorder

ICF: International Classifi cation of Functioning, Disability

and Health

Health Conditiondisorderordisease

thatinformspredictedcomorbiditiesand

prognosis

Body Functions and Structuresanatomicalparts

andtheirphysiological

functions

Environmental and Personal Factors

physical,social,attitudinal,andenvironmentalfactors

andfactorswithintheindividual’slife

Activities and Participation

executionoftasksor

involvementinlifesituations

ADDITIONAL RESOURCES: asha.org/slp/icf/ • who.int/classifi cations/icf/en/

For clinical and documentation questions, contact healthservices@asha.org.The interpretation of ICF and examples above are consensus based and provided as a resource for members of the

American Speech-Language-Hearing Association.

Person-Centered Focus on Function: Xxxxx

10869

Person-Centered Focus on Function: Speech Sound

Assessment Data

Body Functions and Structures

Activities and Participation

(ICSd, FOCUSe, Child and Caregiver Interviews)•Raúlisintelligibletofamily

membersbutisoftenunintelligibletopeers,teachers,andunfamiliaradults.

•Raúlexperiencesfrustrationandsocialisolation(e.g.,isn’tinvitedtochildren’sbirthdayparties,playsaloneontheplayground).

•Raúlhasdifficultymakingfriends.

•Raúlenjoysplayingwithdinosaursandhispets.

Environmental and Personal Factors

•Raúlis5yearsold.

•Heisinkindergarten,withaccesstospeechservices.

•Raúl’soldersistersattendthesameschoolandactasinterpretersforhimontheplayground.

•Raúlhastwofriends,butothersatschoolteasehimabouthisspeech.

•Raúlbecomeseasilyupsetwhenothersdon’tunderstandhim.

•RaúlspeaksSpanishandEnglishathomeandschool.

•Raúl’sfatherandgrandfatherhaveahistoryofspeechsounddisorder.

What impairments most affect function in this setting, based on clinician assessment and individual/family report?

What activities are most important to the

individual in the current setting?

What environmental/ personal characteristics help or hinder participation in activities or

situations in the current setting?

Clinical Reasoning

Goal Setting

Health Condition: Speech Sound

Case study: Raúl

(Formal/Informal Assessments)

Cognitive functioning•Normal

Speech (DEAPa)•EnglishPCCb=78,PVCc=82•DifficultyproducingSpanish

andEnglishconsonantclustersandfricatives

Language (English)•Normalreceptivelanguage•Mildexpressivedifficulty

Oromusculature, swallowing

•Normalstructure+function

Voice/resonance, fluency, hearing•Normal;historyofotitismedia

Early literacy •Poorphonologicalawareness

andletterknowledge

Person-Centered Functional Goals

Long-Term Goal Raúlwillbeunderstood(intelligible)whentalkingwithfriendsandteachersinacademicandsocialcontextsandwilldemonstrateage-appropriateletterknowledgeskillsinatleast50%ofcommunicativeinteractionswithfamiliarandunfamiliarlistenersbytheendoftheacademicschoolyear.

Short-Term Goals •Bytheendoftheschoolterm,Raúlwillproduceconsonantclusterscorrectly(i.e.,reducecluster

reduction)90%ofthetimewithhissisterontheplayground(e.g.,swing,slide,grass,friends,play).•Bytheendofthesemester,Raúlwillusethecorrectnumberofsyllableswhennamingdinosaurs

(90%ofthetime)whileplayingwithafriend.•Bytheendoftheschoolterm,Raúlwillcorrectlyidentifythesoundsandlettersinthenamesof

hissisters,friends,andpetanimals(90%ofthetime)withhisteacher.

a DEAP = Diagnostic Evaluation of Articulation and Phonology (Dodd, Hua, Crosbie, Holm, & Ozanne, 2006).

b PCC = Percentage Consonants Correct.c PVC = Percentage Vowels Correct.

d ICS = Intelligibility in Context Scale (McLeod, Harrison, & McCormack, 2012).

e FOCUS = Focus on Outcomes of Children Under Six (Thomas-Stonell, Robertson, Walker, Oddson, Washington, & Rosenbaum, 2012).

For clinical and documentation questions, contact healthservices@asha.org.The interpretation of ICF and examples above are consensus based and are provided as a resource for members of the American Speech-Language-Hearing Association.